TennCare · A Pillar Guide from Preferred Care at Home
Families call when a parent needs daily help but wants to stay out of a nursing home, and they have heard the name CHOICES without understanding how it works. TennCare CHOICES is Tennessee’s Medicaid pathway for long term care and home and community based services at home. Eligibility and coverage decisions belong to TennCare and your TennCare health plan. This page walks through what TennCare CHOICES in home care actually covers before you call.
Most families reach this page already knowing the name CHOICES but not much else. Here is what the CHOICES program answers before you make that first call.
CHOICES has both medical and financial rules. Age, disability status, and financial category all matter, so eligibility is verified with TennCare, not assumed.
The official CHOICES benefit table lists specific community based services. Personal care visits and attendant care are the two most utilized, and both can support personal in-home care needs at home.
The CHOICES program allows agency-based care and consumer direction. Each has different rules, and companion care has narrower requirements tied to consumer direction specifically.
Approval is one step. Your managed care organization must confirm care can safely meet needs at home, and then your plan of care is built with your provider.
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Picture an elderly parent at 72 who is starting to struggle with getting dressed, moving around the house safely, preparing meals, or keeping up with everyday activities. CHOICES was designed for older adults age 65 and older whose medical and financial situation may qualify them to receive home care services. Whether that means several hours a week of personal care or a broader care plan depends on TennCare's assessment.
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CHOICES also serves adults age 21 and older with a physical disability who need help with daily living activities, moving around, eating, toileting, communicating, and want that help provided in their own home instead of a nursing home. Adults whose primary need relates to an intellectual or developmental disability are typically served through Tennessee's separate ECF CHOICES program, not this one.
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Adult children, spouses, and other family caregivers are trying to keep a loved one home safely while working full-time or managing their own health. If your loved one may qualify, CHOICES may authorize in home respite care, personal care visits, and other supports so you are not carrying everything alone. Approval and hours are set by TennCare and your loved one's health plan.
CHOICES personal care visits are one of the most utilized community based services in the program, along with attendant care. The amount an individual member is authorized for is set by TennCare and the member’s health plan, not by an agency.
Personal care, help with everyday activities, homemaker services, home delivered meals, respite care, and personal emergency response systems can all be part of an authorized plan of care, depending on assessment and health plan approval.
TennCare added new CHOICES benefit categories effective July 1, 2025 — Employment Services and Supports, and Enabling Technology — for members in Groups 2 and 3. Families relying on older explainers can underestimate what may now be available.
Where a local home care team fits — without ever standing in for TennCare or the MCO.
We take your call at (615) 970-3737, learn about your loved one's situation, and explain how CHOICES may fit before anyone signs anything.
We point you to the right TennCare resources, the area agency on aging intake line and the LTSS Help Desk, so approval decisions come from the state, not us.
Your TennCare health plan confirms care can safely meet needs at home and issues a plan of care with authorized services and hours.
We match a caregiver by personality and needs, introduce them to your family, and align our schedule with the authorized plan of care.
Our office manager keeps you informed, our LPN provides clinical oversight, and we adjust as needs change — always within what your plan authorizes.
Preferred Care at Home of Hendersonville is owned by Quin Christensen and Richard Patterson, and both live in the community. They saw firsthand what caregiving does for a family — Quin through his own parents’ health journeys, Richard through five years in the funeral industry watching widows and widowers come home alone.
Our care team includes Melissa Maxfield, a Licensed Practical Nurse who provides clinical oversight, and Lisa Barry, our Transition Liaison who focuses on hospital-to-home transitions. That combination matters when a CHOICES member is moving between settings or has medical needs that require coordination beyond routine personal care.
We hold Certified Preferred Provider status and have been recognized by Home Care Pulse as an Employer of Choice and Provider of Choice in multiple recent years. Our team explains what we do know, points you to TennCare for what only TennCare can answer, and does not guarantee approval or coverage.
For adults 21+ with a physical disability and seniors 65+ who need nursing home care level of support but choose to receive that care at home instead. To be eligible for home care in Group 2, your TennCare health plan must be able to safely meet the person's needs at home. This is the group many families in Hendersonville are actually asking about.
For adults 21+ with a disability and seniors 65+ who do not currently need nursing home care but need certain supports to avoid needing that level of care soon. Group 3 members typically receive a smaller, more targeted service package designed to keep them safely at home longer.
For people of all ages who receive care in a nursing facility rather than at home. CHOICES covers nursing facility services as well as home-based supports. Preferred Care at Home does not provide facility-based care.
Some members hire and manage certain workers directly through consumer direction; others receive services through a licensed agency. Companion care is only available for Group 2 members using consumer direction, and only in narrow situations. We work with families whose plan of care uses agency-based services.
When a loved one's needs approach nursing home care level, families are usually weighing two real options. Both are legitimate. What CHOICES adds is the option to choose home when your health plan agrees needs can be safely met there.
Yes, TennCare, Tennessee's Medicaid program, may pay for home care through a specific program called CHOICES for eligible seniors 65 and older and adults 21 and older with physical disabilities. CHOICES is one part of TennCare's long term services and supports, and eligibility depends on both medical and financial rules confirmed by TennCare. Your TennCare health plan must also determine that your needs can safely be met at home.
Services and the hours attached to them are authorized by your managed care organization, not by any home care agency.
For eligible CHOICES members, in-home services are covered by TennCare, though some members may have a patient liability amount set during the eligibility process. Some people qualify through Supplemental Security Income. Per TennCare's eligibility categories page, the SSI limit is $994 monthly for one person and $1,491 for two.
Others qualify for Medicaid long term services through the Institutionalized Individuals or HCBS financial category, which sets a $2,982 monthly income limit and a $2,000 resource limit for a one-person household. Your local area agency on aging can walk through which pathway applies to your loved one.
CHOICES home care is for adults 21 and older with a physical disability and seniors 65 and older who meet both medical need and financial rules under TennCare. Qualifying medically means needing help with daily living activities like moving around, eating, toileting, or communicating. Qualifying financially means falling into a category TennCare confirms, and for home care specifically, your health plan must determine that care can safely meet those needs at home.
Adults whose primary need is intellectual or developmental disability are served through ECF CHOICES, a different Tennessee program from the one this page describes.
Group 2 is for adults 21 and older with a physical disability and seniors 65 and older who need nursing home care level of support but choose to receive that care at home. Group 3 is for people at similar ages and disability status who do not need nursing home care right now but need supports to avoid needing that level of care soon. Group 2 typically receives a broader service package, while Group 3 receives a more targeted set of term services and supports focused on prevention.
Group assignment is made by TennCare and the member's health plan, not by any home care agency.
In some situations, yes. The TennCare CHOICES program allows consumer direction, which lets certain members hire and manage some of their own workers, and eligible family members may be paid for authorized services in that model. Consumer direction has its own rules, and not all services are available through it.
Companion care in particular is only available for Group 2 members using consumer direction, and only when it costs less than other authorized home care that would meet the same needs. Confirm the details with TennCare or the member's health plan before making a hiring decision.
TennCare CHOICES does not cover services outside the official CHOICES benefit table, and it does not automatically cover every household task or service a family might want. Covered services must appear in the CHOICES benefit array: personal care visits, attendant care, homemaker services, home delivered meals, in home respite care, personal emergency response systems, minor home modifications like grab bars, assistive technology, and a few others, each with its own limits. CHOICES is also separate from ECF CHOICES, which serves people whose primary need relates to an intellectual or developmental disability rather than a physical one.
Timelines vary because CHOICES approval involves multiple steps: application, medical and financial eligibility review, and then health plan authorization for a plan of care. Start by calling your local area agency on aging at the toll free number 1-866-836-6678, or the LTSS Help Desk at 1-877-224-0219, to begin the application process.
TennCare reviews eligibility, and upon approval, your health plan assesses whether needs can safely be met at home before building the plan of care in a timely manner. If you want help understanding where you are in that sequence, call us at (615) 970-3737.
No, approval, group assignment, and service authorization decisions are made by TennCare and the member's health plan, not by any home care agency. We help families understand TennCare CHOICES in long term care, connect them to the right TennCare resources, and provide care that fits within an authorized plan of care once one exists.
What we do not do is promise eligibility, promise hours, or bill TennCare on behalf of a family that has not been approved and authorized. Call (615) 970-3737 to talk through your specific situation.
Every situation is different. Yours deserves a real conversation.
Call our Hendersonville office and we’ll walk you through what CHOICES may look like for your family — (615) 970-3737
